Alexandra Rouquette: preventing mental health disorders in children and adolescents
Alexandra Rouquette is a lecturer at the Centre for Research in Epidemiology and Public Health (CESP - Univ. Paris-Saclay, UVSQ, Inserm) and Deputy Director of Education at the Public Health Graduate School at Université Paris-Saclay. She specializes in psychometrics and methodology for the study of subjective phenomena in mental health, particularly in children and adolescents.
After studying for the preparatory course for the competitive exam in Biology, Chemistry, Physics and Earth Sciences at the Lycée Saint Louis in Paris, Alexandra Rouquette began studying medicine in 1997 at Université Paris-Sud (which is Université Paris-Saclay today). During her work placement in public health, she completed a year of study in 2007 at the École Nationale de Santé Publique de Rennes (now the École des Hautes Études en Santé Publique or EHESP). She then decided to focus on mental health research. In 2008, she studied for a 2-year Master's degree in public health research with a speciality in biostatistics at Université Paris-Sud. This provided her with the opportunity to complete a work placement at the Paris-Sud Innovation Group in Adolescent Mental Health (PSIGIAM) unit. In 2010, thanks to a research year and a Marie-Curie travel grant, she went to Canada to study for a PhD which was jointly supervised by Université Paris-Sud and Université de Montréal. The PhD’s title was “Subjective measures and epidemiology, methodological problems related to the use of psychometrics”. Epidemiology is a discipline which studies the frequency and distribution of diseases, whether infectious, acute or chronic (including psychiatric), and seeks to identify their aetiology.
Psychometrics and research methodology
Following her work placement, Alexandra Rouquette has specialised in psychometrics and research methodology in psychiatry. Psychometrics are used to measure subjective health phenomena, such as depression, anxiety or quality of life, through questionnaires. “These subjective phenomena are particularly difficult to measure without involving the judgement of the subject themselves.” In epidemiology, the questionnaires are used, for example, in cohort studies - individuals selected at random from the general population or with similar conditions and followed over time - to study the frequency and risk factors for the occurrence of mental health disorders. They consist of questions regarding the expression of the subjective phenomenon. For example, to assess depression, questions are asked about the level of sadness, lack of energy, loss of appetite, etc. The scores generated indicate the intensity of the phenomenon so that its evolution and variability factors can be studied over time. These studies provide essential information for initiating campaigns to prevent the occurrence of these disorders and to promote mental health.
The Public Assistance - Paris Hospitals (AP-HP)
In 2012, Alexandra Rouquette joined the AP-HP as a university hospital assistant in the biostatistics and epidemiology unit of the Hôtel-Dieu hospital in Paris and Université Paris-Descartes. Her mandate was threefold. She advised health care staff wishing to conduct clinical or epidemiological research projects on the most appropriate methodology for their chosen research question. She also taught biostatistics and epidemiology. And once her PhD was defended in 2014, she continued with her field of research within the Mental Health and Public Health unit (Univ. Paris-Saclay, Inserm, Univ. Paris Cité) at the Maison de Solenn, la Maison des Adolescents de Cochin (the Teenagers' House at Cochin). In 2020, this unit merged with the Centre for Research in Epidemiology and Public Health (CESP - Univ. Paris-Saclay, UVSQ, INSERM), where she is currently conducting research as part of the Developmental Psychiatry and Trajectories team. In 2017, she joined Université Paris-Saclay as an associate professor and hospital practitioner in the Public Health and Epidemiology Department at Bicêtre hospital.
The study of mental health during development
Alexandra Rouquette is particularly interested in studying the evolution of the expression of subjective phenomena over time. “Depression is not expressed in the same way in childhood, adolescence and adulthood. As a result, I’m studying how to reliably and meaningfully measure subjective phenomena during development.” This difference in expression may also be related to other socio-demographic characteristics, such as gender or cultural background.
An unprecedented discovery thanks to the network analysis method
In 2017, she spent four months abroad at the PsychoSystem research group at the University of Amsterdam as a visiting scholar. There, the lecturer learnt about network analysis - an innovative method for the analysis of psychometric data - and applied it to longitudinal data. “We applied this method to data from a cohort of children in Quebec who’d been followed for thirty years and, for the first time, we found a link between certain symptoms expressed by the children according to their parents (irritability, dislike of other children at school, loneliness) and the occurrence of depressive or anxiety disorders developed in adolescence or adulthood.” This study was of particular interest to child psychiatrists to help them better identify the vulnerability of certain children.
The Covid-19 pandemic and its impact on mental health
Thanks to her expertise, during the pandemic Alexandra Rouquette was asked to help with setting up the Epidemiology and Living Conditions under Covid-19 (EpiCov) national cohort and with the Health, Practices, Relationships and Social Inequalities in the General Population during the COVID-19 Crisis (SAPRIS) survey. “We found, among other things, that 15 to 30 year olds were particularly affected by depression and anxiety disorders at the onset of the crisis; and that children from low socio-economic backgrounds had significantly more emotional symptoms, hyperactivity and attention disorders than others.”
Since 2016, Alexandra Rouquette and other researchers in France, Belgium and Switzerland have set up the RéFLiS network on health literacy throughout the French-speaking world. This project addresses a current topic of interest in public health, and particularly in mental health, as it involves assessing the ability of individuals to access, understand and review health information in order to make good decisions about their own health. “It’s intended to encourage key players in public health to develop actions to improve this potential. For example, research shows that among individuals with diabetes, having good health literacy is associated with better disease outcomes.”
The Public Health Graduate School at Université Paris-Saclay
Alexandra Rouquette has been Deputy Director of Education at the Public Health Graduate School at Université Paris-Saclay since 2020. The School offers two Masters’ degrees in Public Health and Ethics, a Public Health doctoral school, several University Diplomas and a Public Health summer school. The researcher is committed to developing multidisciplinarity within the Graduate School. “In order for them to become good public health professionals, we need to train students in all the methods used in the field, from biostatistics, epidemiology and computer science to economics, law and sociology.” With this in mind, Alexandra Rouquette promotes links with other Graduate Schools, such as Computer Sciences or Sociology and Political Science.